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A Tale of Two Keynotes: Futurist Joe Flower and Aetna’s Mark Bertolini

This year at Health 2.0’s Annual Conference, two speakers split stage time during the opening keynote. Joe Flower, a health futurist, and Mark Bertolini, CEO of health insurer Aetna, don’t have a whole lot in common professionally. But in their talks they both made clear that they hold two beliefs in common: the United States health care system needs to react to the country’s cost crisis, and efforts to address health care costs will happen independently from federal reform.

Flower spoke first, laying out the tenets of what he calls the Next Health Care. For such an optimistic speech, it was filled with negatives. Flower went through step by step, talking about what the nation isn’t doing right now, who’s not invested in better care, and why all health care systems can’t just become Kaisers.

Though the talk certainly wasn’t meant to praise health care for all it does right, it was meant to point out the promise that the health care system could be on the brink of.

“Health care is undergoing fundamental economic changes,” Flower said. “These changes are driving us to what may well be better and cheaper health care for everyone.”

The Affordable Care Act isn’t what’s propelling those changes, according to Flower. It’s other factors including an aging population, the sheer cost of care in the U.S., and technological capability that we’ve never seen until now.

He showed some ominous graphics that predicted what the country could look like in the coming years if we stay on the course we’re on. Chronic disease accounts for 70 to 75% of all health care costs, Flower said. And as many Americans know, obesity is a huge contributor to those costs. The maps looked at the projection of obesity rates in the U.S. over time, and as the slides passed it looked like the country was being eaten by the disease.

“Now, some of the best hopes for that future, honestly, we see right here at Health 2.0. But we are not there yet,” Flower said.

The country is on the brink of fundamental shifts, he said. There are five components needed to get to the Next Health Care: explode the business model, build on smart primary care, put a crew on it, swarm the customer, and rebuild all processes. Many of these blend into one another. For example, take Flower’s contested belief that primary care can thrive in the future.

“This has to be built on primary care. Built on smart primary care,” Flower said. “The emphasis is on smart.”

In order to deliver smart primary care, providers need to have the ability to swarm their patients ― in other words, use all of the data at their disposal to treat the ones that most need care at the time that they need it.

And data will be key in all areas of care delivery. Especially when it comes to pinpointing exactly how the U.S. will lower costs.

“On the revenue side there is this tremendous complexity that is getting more complex. Because we’re not suddenly all becoming Kaiser. We’re not moving massively to some new model.”

“We have the old model which has all kinds of complexities already, and then we’re layering in on top all kinds of new revenue streams, whose incentives are exactly the opposite of the old existing revenue streams,” Flower said.

Bertolini got on stage next, saying that Flower helped him transition well into his talk. Bertolini said, too, that it’s technology, not the law, that has the most potential to affect health care costs in this country.

“I’ll show you some pretty cool new technology that we’re using to empower health systems to put insurers out of business,” Bertolini said. The comment was followed by the audience’s delayed laughter.

The CEO went onto describe what Aetna’s been doing to integrate technology into its offerings in the past year. A year ago, Aetna introduced iNexx, a health app store for physicians. The apps are meant to assist doctors with Meaningful Use, workflow management, clinical decision support, and more. Bertolini said that last year the store had 280 practices as customers, and this year it has 9,000.

“Doctors will use apps. As a matter of fact, they’ll download them in ways that will make their practices more efficient,” Bertolini said.

He transitioned to iTriage, explaining why the acquisition of the patient-facing app was a no-brainer. It was all about creating ease.

“While we were working with the physician and provider system, what we didn’t have was a way to connect the consumer to the health care system in a very convenient way,” Bertolini said.

Bertolini also discussed Aetna’s CarePass, a platform that aggregates data from a number of consumer apps and allows health information to flow between those apps and a personal cloud.

Bertolini didn’t at all dive into specifics about how these apps and platforms will contribute to lower health care costs, but Aetna’s recent focus on consumer technology implies that the company thinks patients will have a big roll in bending the cost curve.

At the same time it won’t be just one part of the health care system that has the ultimate effect. In a Health 2.0 space that’s getting very crowded ― both literally and at this conference of more than 1,500 attendees ― is there more room in this Next Health Care System than we think?